Governance survey 2024

Quality of board governance is holding up, despite trusts being under significant, sustained pressure.
Recent national guidance has been broadly positively received (the chair appraisal, fit and proper persons test, leadership competency frameworks, and the insightful provider boards guidance). Respondents were most critical of the chair appraisal framework.
Respondents consistently expressed concerns about proposals to introduce league tables and pay linked to performance, noting that the factors driving performance are inherently complex, and withholding pay is contrary to a supportive improvement culture.
Some trusts are experiencing difficulty recruiting executive and non-executive directors, including chairs. Respondents reported a reduction in the number and quality of applicants.
Trusts' experience of system governance remains variable, but is improving overall. These are explored below, and further detail can be found in the full report.